TRICYCLIC HETEROCYCLIC COMPOUNDS AS 5-HT4 RECEPTOR ANTAGONISTS

Abstract: Compounds of formula (I) or a pharmaceutically acceptable salt thereof, wherein X1-(CH2)x-X2 and the aromatic carbon atoms to which they are attached form a 5-7 membered ring wherein X1 is O or S; X2 is O, S, NRs or NRsCO wherein Rs is hydrogen or C1-6 alkyl; or one of X1 and X2 is O, S or CH2 and the other is CH2; x is 1, 2 or 3; R1 and R2 together are Q-CH2-CH2, Q-CH = CH, or Q-CH = N where Q is linked either to the R1 or the R2 substitution position and Q is O, S or NRt wherein Rt is hydrogen or C1-6 alkyl; R3 is hydrogen, halo, C1-6 alkyl, C1-6 alkoxy or amino; R4<1> and R4<2> are independently hydrogen or C1-6 alkyl; Y is O or NH; Z is of sub-formula (a), (b) or (c) and their use as pharmaceuticals in the treatment of gastrointestinal disorders, cardiovascular disorders and CNS disorders.

Description: TRICYCLIC HETEROCYCUC COMPOUNDS AS 5-HT4 RECEPTOR ANTAGONISTS This invention relates to novel compounds having pharmacological activity, to a process for their preparation and to their use as pharmaceuticals. European Journal of Pharmacology 146 (1988), 187-188, and Naunyn-Schmiedeberg's Arch. Pharmacol. (1989) 340:403-410, describe a non classical 5-hydroxytryptamine receptor, now designated the 5-HT4 receptor, and that ICS 205-930, which is also a 5-HT3 receptor antagonist, acts as an antagonist at this receptor. WO 91/16045 (SmithKline and French Laboratories Limited) describes the use of cardiac 5-HT4 receptor antagonists in the treatment of atrial arrhythmias and stroke. EP-A-501322 (Glaxo Group Limited), WO 93/02677, WO 93/03725, WO 93/05038, WO 93/05040, WO 93/18036, and PCT/EP93/03054 (SmithKline Beecham pic) describe compounds having 5-HT4 receptor antagonist activity. It has now been discovered that certain novel compounds also have 5-HT4 receptor antagonist properties. EP-A-234872 (Adria), US 4859683 (Rorer) and EP-A-307172 (Lilly) describe 5-HT3 receptor antagonists derived from a benzoic acid nucleus, 2,3-disubstituted by alkyleneoxy. A class of novel, structurally distinct compounds has now been discovered, which compounds are fused tricyclic derivatives incorporating and linking through a core which is a phenyl ring. These compounds have 5-HT4 receptor antagonist activity. Accordingly, the present invention provides a compound of formula (I), or a pharmaceutically acceptable salt thereof: (I) wherein in which Xj-(CH2)χ-X2 an the aromatic carbon atoms to which they are attached form a 5-7 membered ring wherein X\ is O or S; X2 is O, S, NR S or NR s CO wherein R s is hydrogen or Ci.g alkyl;or one of Xi and X2 is O, S or CH2 and the other is CH2; x is 1, 2 or 3; Ri and R2 together are Q-CH2-CH2, Q-CH=CH, or Q-CH=N where Q is linked either to the Rj or the R2 substutution position and Q is O, S or NR t wherein R l is hydrogen or Cj.g alkyl; R3 is hydrogen, halo, Cj.g alkyl, C\. alkoxy or amino; R4I and R4 are independently hydrogen or C \.(, alkyl; Y is O or NH; Z is of sub-formula (a), (b) or (c): (a) (b) (c) wherein n- is 1, 2, 3 or 4; n-- is 0, 1, 2, 3 or 4; n-- is 2, 3, 4 or 5; q is 0, 1, 2 or 3; p is 0, 1 or 2; m is 0, 1 or 2; R5 is hydrogen, C * _i2 alkyl, aralkyl or R5 is (CH2) z -Rιo wherein z is 2 or 3 and RjO is selected from cyano, hydroxyl, C-μg alkoxy, phenoxy, C(O)Cι_g alkyl, COC6H5, -CONR! !Ri2, NRi jCOR^, S02NR! 1^2 or NRj 1 S0 2 Ri2 wherein R\ \ and R γ are hydrogen or C 1. alkyl; or R5 is straight or branched chain alkylene of chain length 1-6 carbon atoms terminally substituted by aryl, 3 to 8 membered cycloalkyl, 3 to 8 membered heterocyclyl, 5 or 6 membered monocyclic heteroaryl or 9 or 10 membered fused bicyclic heteroaryl linked through carbon, C2-7 alkoxycarbonyl, or secondary or tertiary hydroxy substituted Cj.g alkyl; ; and Rg, Rγ and Rg are independently hydrogen or Cj.g alkyl; and R9 is hydrogen or C 1 _ 10 alky 1 ; or a compound of formula (I) wherein the CO-Y linkage is replaced by a heterocyclic bioisostere; having 5-HT4 receptor antagonist activity. Examples of alkyl or alkyl containing groups include C\, C2, C3, C4, C5, , C7, C%, C9, CJQ, C] 1 or C12 branched, straight chained or cyclic alkyl, as appropriate. Cj_4 alkyl groups include methyl, ethyl, n- and wσ-propyl, n-, iso-, sec- and tert-butyl. Cyclic alkyl includes cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl and cyclooctyl. Aryl includes phenyl and naphthyl optionally substituted by one or more substituents selected from halo, C\.β alkyl and C\. alkoxy. Values for monocyclic heteroaryl include pyridyl, pyrimidyl, pyrazinyl, pyrryl, imidazolyl, thienyl, furanyl, oxazole or thiazole (all possible isomers). Bicyclic heteroaryl include benzofuranyl, benzothiophenyl, indolyl and indazolyl, quinolyl and woquinolyl (all possible isomers). Values for 3 to 8 membered heterocyclyl, include cyclic polymethylene interrupted by one or two of N, O or S, linked through C or N, for example N-linked piperidinyl or pyrrolidinyl. Halo includes fluoro, chloro, bromo and iodo. A suitable bioisostere for the amide or ester linkage containing Y in formula (I), is of formula (d): (d) wherein the dotted circle represents one or two double bonds in any position in the 5- membered ring; H, J and I independently represent oxygen, sulphur, nitrogen or carbon, provided that at least one of H, J and I is other than carbon; U represents nitrogen or carbon. Suitable examples of (d) are as described for X, Y and Z in EP-A-328200 (Merck Sharp & Dohme Ltd.), such as an oxadiazole moiety. A suitable value of Q is NR, such as NH. Suitable examples of the X]-(CH2) X -X2 moiety include O-(CH2)2"O, O-(CH )3-O, O-CH 2 -O, O-(CH 2 )2-NR4, O-(CH 2 )2-S or O-CH 2 -CONR , wherein any of the methylene linkages are optionally mono- or di- substituted by Ci.g alkyl groups, such as methyl. Preferably such Xj-(CH2)2-X2 ** s 0-(CH2)2"0. Further suitable examples of the X]-(CH2. X -X2 include 0-(CH2)2-CH2, O-(CH2)3-CH2, O-CH2-CH2, or corresponding values wherein X\ = X2 = CH2, wherein any of the methylene linkages are optionally mono- or di-substituted by Cj.g alkyl groups, such as methyl. Preferably such X]-(CH2)2-X2 is 0-(CH2)2-CH2- R4 and R5 are often hydrogen. When R4/R5 is C . alkyl, it is often methyl. In particular R4 and R5 are methyl such that the disubstiluent containing X\ and X2 is O-C(CH 3 ) 2 -O. R3 is preferably hydrogen. Y is preferably O or NH. When Z is of sub-formula (a), n- is preferably 2, 3 or 4 when the azacycle is attached at the nitrogen atom and n- is preferably 1 when the azacycle is attached at a carbon atom, such as the 4-position when q is 2. When Z is of sub-formula (b), n**** is preferably such that the number of carbon atoms between the ester or amide linkage is from 2 to 4 carbon atoms. Suitable values for p and m include p = m = 1; p = 0, m = 1, p = 1, m = 2, p = 2, m = 1. When Z is of sub-formula (c), rβ is preferably 2, 3 or 4. Rg and R9 are preferably both alkyl, especially one of Rg and R9 is C4 or larger alkyl. Specific values of Z of particular interest are as follows: -NMe π Bu (iv) The invention also provides novel compounds within formula (I) with side chains (i), (ii), (iii), (iv), (v), (vi) or (vii). In a further aspect, the piperidine ring in (i), (ii) or (iii) may be replaced by pyrrolidinyl or azetidinyl, and or the N-substituent in (i) or (ii) may be replaced by C3 or larger alkyl or optionally substituted benzyl. In an alternative aspect, the N-substituent in formula (i) or (ii) may be replaced by (CH2) n R^ as defined in formula (I) and in relation to the specific examples of EP-A-501322, or it may be replaced by a substituent The pharmaceutically acceptable salts of the compounds of the formula (I) include acid addition salts with conventional acids such as hydrochloric, hydrobromic, boric, phosphoric, sulphuric acids and pharmaceutically acceptable organic acids such as acetic, tartaric, maleic, citric, succinic, benzoic, ascorbic, methanesulphonic, cc-keto glutaric, α-glycerophosphoric, and glucose- 1 -phosphoric acids. Examples of pharmaceutically acceptable salts include quaternary derivatives of the compounds of formula (I) such as the compounds quaternised by compounds R x -T wherein R x is Cι_6 alkyl, phenyl-C-μβ alkyl or C5.7 cycloalkyl, and T is a radical corresponding to an anion of an acid. Suitable examples of R x include methyl, ethyl and n- and wø-propyl; and benzyl and phenethyl. Suitable examples of T include halide such as chloride, bromide and iodide. Examples of pharmaceutically acceptable salts also include internal salts such as N-oxides. The compounds of the formula (I), their pharmaceutically acceptable salts, (including quaternary derivatives and N-oxides) may also form pharmaceutically acceptable solvates, such as hydrates, which are included wherever a compound of formula (I) or a salt thereof is herein referred to. It will also be realised that the (CH2) n 2 moiety in compounds of formula (I) wherein Z is (b), may adopt an α or β or configuration with respect to the fused azabicyclic moiety. The compounds of formula (I) may be prepared by conventional coupling of the X1/X2 moiety with Z. Suitable methods are as described in GB 2125398A (Sandoz Limited), GB 1593146A and EP-A-36269 (Beecham Group p.l.c), EP-A-429984 (Nisshin Flour Milling Co.) and EP-A-328200 (Merck Sharp & Dohme Limited). Reference is also made to EP-A-501322 (Glaxo Group Limited). Aza(bi)cyclic side chain intermediates are known compounds or may be prepared according to the methods described in the aforementioned patent publications in the name of SmithKline Beecham p.l.c. The compounds of the present invention are 5-HT4 receptor antagonists and it is thus believed may generally be used in the treatment or prophylaxis of gastrointestinal disorders, cardiovascular disorders and CNS disorders. They are of potential interest in the treatment of irritable bowel syndrome (IBS), in particular the diarrhoea aspects of IBS, i.e., these compounds block the ability of 5-HT to stimulate gut motility via activation of enteric neurones. In animal models of IBS, this can be conveniently measured as a reduction of the rate of defaecation. They are also of potential use in the treatment of urinary incontinence which is often associated with IBS. They may also be of potential use in other gastrointestinal disorders, such as those associated with upper gut motility, and as antiemetics. In particular, they are of potential use in the treatment of the nausea and gastric symptoms of gastro- oesophageal reflux disease and dyspepsia. Antiemetic activity is determined in known animal models of cytotoxic-agent radiation induced emesis. Specific cardiac 5-HT4 receptor antagonists which prevent atrial fibrillation and other atrial arrhythmias associated with 5-HT, would also be expected to reduce occurrence of stroke (see A.J. Kaumann 1990, Naumyn-Schmiedeberg's Arch. Pharmacol. 342, 619-622, for appropriate animal test method). Anxiolytic activity is likely to be effected via the hippocampus (Dumuis et a! 1988, Mol Pharmacol., 34, 880-887). Activity can be demonstrated in standard animal models, the social interaction test and the X-maze test. Migraine sufferers often undergo situations of anxiety and emotional stress that precede the appearance of headache (Sachs, 1985, Migraine, Pan Books, London). It has also been observed that during and within 48 hours of a migraine attack, cyclic AMP levels are considerably increased in the cerebrospinal fluid (Welch et al., 1976, Headache 16, 160-167). It is believed that a migraine, including the prodomal phase and the associated increased levels of cyclic AMP are related to stimulation of 5-HT4 receptors, and hence that administration of a 5-HT4 antagonist is of potential benefit in relieving a migraine attack. Other CNS disorders of interest include schizophrenia, Parkinson's disease and Huntingdon's chorea. The invention also provides a pharmaceutical composition comprising a compound of formula (I), or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier. Such compositions are prepared by admixture and are usually adapted for enteral such as oral, nasal or rectal, or parenteral administration, and as such may be in the form of tablets, capsules, oral liquid preparations, powders, granules, lozenges, reconstitutable powders, nasal sprays, suppositories, injectable and infusable solutions or suspensions. Orally administrable compositions are preferred, since they are more convenient for general use. Tablets and capsules for oral administration are usually presented in a unit dose, and contain conventional excipients such as binding agents, fillers, diluents, tabletting agents, lubricants, disintegrants, colourants, flavourings, and wetting agents. The tablets may be coated according to well known methods in the art, for example with an enteric coating. Suitable fillers for use include cellulose, mannitol, lactose and other similar agents. Suitable disintegrants include starch, polyvinylpolypyrrolidone and starch derivatives such as sodium starch glycollate. Suitable lubricants include, for example, magnesium stearate. Suitable pharmaceutically acceptable wetting agents include sodium lauryl sulphate. Oral liquid preparations may be in the form of, for example, aqueous or oily suspensions, solutions, emulsions, syrups, or elixirs, or may be presented as a dry product for reconstitution with water or other suitable vehicle before use. Such liquid preparations may contain conventional additives such as suspending agents, for example sorbitol, syrup, methyl cellulose, gelatin, hydroxyethylcellulose, carboxymethylcellulose, aluminium stearate gel or hydrogenated edible fats, emulsifying agents, for example lecithin, sorbitan monooleate, or acacia; non-aqueous vehicles (which may include edible oils), for example, almond oil, fractionated coconut oil, oily esters such as esters of glycerine, propylene glycol, or ethyl alcohol; preservatives, for example methyl or propyl /? -hydroxybenzoate or sorbic acid, and if desired conventional flavouring or colouring agents. Oral liquid preparations are usually in the form of aqueous or oily suspensions, solutions, emulsions, syrups, or elixirs or are presented as a dry product for reconstitution with water or other suitable vehicle before use. Such liquid preparations may contain conventional additives such as suspending agents, emulsifying agents, non-aqueous vehicles (which may include edible oils), preservatives, and flavouring or colouring agents. The oral compositions may be prepared by conventional methods of blending, filling or tabletting. Repeated blending operations may be used to distribute the active agent throughout those compositions employing large quantities of fillers. Such operations are, of course, conventional in the art. For parenteral administration, fluid unit dose forms are prepared containing a compound of the present invention and a sterile vehicle. The compound, depending on the vehicle and the concentration, can be either suspended or dissolved. Parenteral solutions are normally prepared by dissolving the compound in a vehicle and filter sterilising before filling into a suitable vial or ampoule and sealing. Advantageously, adjuvants such as a local anaesthetic, preservatives and buffering agents are also dissolved in the vehicle. To enhance the stability, the composition can be frozen after filling into the vial and the water removed under vacuum. Parenteral suspensions are prepared in substantially the same manner except that the compound is suspended in the vehicle instead of being dissolved and sterilised by exposure of ethylene oxide before suspending in the sterile vehicle. Advantageously, a surfactant or wetting agent is included in the composition to facilitate uniform distribution of the compound of the invention. The invention further provides a method of treatment or prophylaxis of irritable bowel syndrome, dyspepsia, atrial arrhythmias and stroke, anxiety and or migraine in mammals, such as humans, which comprises the administration of an effective amount of a compound of the formula (I) or a pharmaceutically acceptable salt thereof. An amount effective to treat the disorders hereinbefore described depends on the relative efficacies of the compounds of the invention, the nature and severity of the disorder being treated and the weight of the mammal. However, a unit dose for a 70kg adult will normally contain 0.05 to lOOOmg for example 0.5 to 500mg, of the compound of the invention. Unit doses may be administered once or more than once a day, for example, 2, 3 or 4 times a day, more usually 1 to 3 times a day, that is in the range of approximately 0.0001 to 50mg/kg/day, more usually 0.0002 to 25 mg/kg/day. No adverse toxicological effects are indicated within the aforementioned dosage ranges. The invention also provides a compound of formula (I) or a pharmaceutically acceptable salt thereof for use as an active therapeutic substance, in particular for use in the treatment of irritable bowel syndrome, gastro-oesophageal reflux disease, dyspepsia, atrial arrhythmias and stroke, anxiety and/or migraine. The following Examples illustrates the preparation of compounds of formula (I), and the following Descriptions relate to the preparation of intermediates. Description 1 A stirred solution of 8-acetamido-l,4-benzodioxan-5-carboxylic acid (GB 1 571 278) (2.5g, 0.0105 mole) in methanol (60 ml) was treated with concentrated sulphuric acid (2 ml) and the solution kept at room temperature for 20 hours, then concentrated in vac o to approxiamately 10 ml volume. The residue was treated with water (30 ml), basified with potassium carbonate and a precipitate was produced. This was filtered off, washed with water and dried to afford methyl 8-amino-l,4-benzodioxan-5- carboxylate as a white solid (1.96g, 89%). l H NMR (CDCI3) 5: 7.38(d,lH), 6.28(d,lH), 4.25-4.43(m,4H), 4.12(br s,2H), 3.83(s,3H). b) Concentrated sulphuric acid (6.5 ml) was treated cautiously with stirring at 5- 10°C with glacial acetic acid (12 ml) and to the resulting solution was added methyl 8-amino- 1 ,4-benzodioxan-5-carboxylate (1.5g, 0.0072 mole). The mixture was stirred at room temperature for 1 h, then treated portionwise over 45 minutes with potassium nitrate (0.85g, 0.0084 mole). The mixture was stirred for a further 4 h then poured into water (100 ml) and basified with potassium carbonate. A precipitate was produced and this was filtered off, washed with water and dried to afford methyl 8- amino-7-nitro-l,4-benzodioxan-5-carboxylate as a yellow solid (0.30g). The filtrate was extracted with ethyl acetate and the extract dried (Na2Sθ4) and concentrated in vacuo to afford a further l.lg of the product as an orange solid. l NMR (CDCI3) δ: 8.50(s,lH), 6.0-7.0(v br,2H), 4.30-4.55(m,4H), 3.87(s,3H). c) A stirred suspension of methyl 8-amino-7-nitro-l,4-benzodioxan-5- carboxylate (300mg, 0.0012 mole) in ethanol (30 ml) together with glacial acetic acid (5 ml) was hydrogenated over 10% Pd-C (lOOmg) at atmospheric pressure and temperature for 5 h. The catalyst was filtered off and the filtrate concentrated in vacuo. The residue was basified with concentrated potassium carbonate solution and extracted with ethyl acetate. The extract was dried (Na2Sθ4) and concentrated in vacuo to afford methyl 7,8-diamino-l,4-benzodioxan-5-carboxylate as a beige solid (240mg, 92%). !H NMR (CDCI3) δ: 6.91(s,lH), 4.21(s,4H), 3.96(br s.2H), 3.74(s,3H), 3.0(br s,2H). d) A solution of methyl 7,8-diamino-l,4-dioxan-5-carboxylate (240mg, 1.07 mmole) in formic acid (15 ml) was heated under reflux for 3 h. The solution was concentrated in vacuo and the residue basified with potassium carbonate solution and a white solid was produced. This was filtered off, washed with water and dried to give methyl 1 H-7,8-dihydro-[ 1 ,4]-dioxino[2,3-g]benzimidazole-5-carboxylate (l lθmg.44%). 1 H NMR (d 6 DMSO) δ: 8.19(s,lH), 7.55(s,lH), 4.30-4.45(m,4H), 3.78(s,3H), 3.6 (v br, 1H). Description 2 (l-ButyI-4-piperidinyI)methanol A mixture of ethyl isonipecotate (102g, 0.65 mole) and 1-bromobutane (72 ml, 0.67 mole) in ethanol (1.2L) was treated with anhydrous potassium carbonate (180g, 1.3 mole) and heated under reflux for 2h. The mixture was allowed to cool and then filtered through kieselguhr. The filtrate was concentrated in vacuo to leave a yellow oil, which was dissolved in ether (300 ml) and added dropwise over 20 minutes to a stirred suspension of lithium aluminium hydride (50g, 1.3 mole) in ether (500 ml) at 0°C under nitrogen. The mixture was stirred at room temperature for 18h, then cooled to 0°C and treated with water (50 ml), 10% NaOH solution (50ml) and water (150ml). The mixture was filtered through keiselguhr and the filtrate concentrated under vacuum to leave a pale yellow oil, which was distilled to afford the title compound (D2) as a colourless oil (88.5g, 80%) bp 102-108°C at 0.1 mm Hg. 1H NMR (CDCI3) δ: 3.48(d,2H), 2.88-3.03(m,2H), 2.25-2.38(m,2H), 2.10(br s, 1H), 1.66-2.00(m,4H), 1.17-1.60(m,7H), 0.90(t,3H). Example 1 (l-Butyl-4-piperidinyl)methyl lH-7,8-dihydro-[l,4]- dioxino[2,3-g]benzimidazole-5-carboxylate [R1-R2 = -NH-CH=N-, R3 = H, R4IR4 2 = H, X X 2 = O, x = 2, Y = O, Z = (i)] A stirred solution of (l-butyl-4-piperidinyl)methanol (D2, 290 mg, 0.0017 mole) in THF (20 ml) under argon at 5°C was treated with 1.5M methyllithium in ether (0.67 ml, 0.0010 mole). After 10 minutes the solution was treated with solid methyl 1H- 7,8-dihydro-[l,4]-dioxino[2,3-g]benzimidazole-5-carboxylate (Dl, 100 mg, 0.43 mmole) and heated under reflux for 3h. The mixture was then treated dry with DMF (15 ml) to aid solubility, followed by more methyl lH-7,8-dihydro-[l,4]- dioxino[2,3-g]bcnzimidazole-5-carboxylate (200mg, 0.86 mmole) and (l-butyl-4- piperidinyl)methanol (290 mg, 0.0017 mole) and heated under reflux for 6h. The mixture was allowed to cool, then concentrated in vacuo and the residue treated with 10% Na2CO3 solution and extracted with chloroform. The extract was dried (Na2S04) and concentrated in vacuo to afford a beige solid, which was washed with n-pentane to remove excess alcohol and then chromatographed on silica gel eluting with 0-10% methanol chloroform. The title compound was obtained as a beige solid (60mg), which was converted to its oxalate salt and crystallised from acetone as a beige solid mp 123-127°C. 1H NMR (CDCI3) δ: 8.15(s,lH), 7.70(s,lH), 6.5-8.5(v br, IH), 4.39(m,4H), 4.18(d,2H), 3.12(br d, 2H), 2.40-2.55(m,2H), 2.00-2.20(m,2H), 1.75-1.95(m,3H), 1.46- 1.72(m,4H), 1.20- 1.43(m,2H), 0.91 (t,3H). The following compounds are prepared from the corresponding acid and lithium - (1- butyl-4-piperidinyl)methoxide via the imidazolidc. (l-Butyl-4-piperidinyl)methyl lH-7,8- dihydropyrano[l,4-g]dioxino[2,3-g]carboxylate [R1-R2 = -NH-CH=CH-, R3 = H, R4IR4 2 = H, Xι,X 2 = O, x = 2, Y = O, Z = (i)] (l-Butyl-4-piperidinyl)methyl lH-3,7,8,9- tetrahydropyrano[3,2-e]indolecarboxylate [R1-R2 = -C=CH-NH-, R3 = H, R4IR4 2 = H, Xι= O, X 2 = CH 2 x = 2, Y = O, Z = (i)] 5-HT4 RECEPTOR ANTAGONIST ACTIVITY 1) Guinea pig colon Male guinea-pigs, weighing 250-400g are used. Longitudinal muscle- myenteric plexus preparations, approximately 3cm long, are obtained from the distal colon region. These are suspended under a 0.5g load in isolated tissue baths containing Krebs solution bubbled with 5% CO2 in O2 and maintained at 37°C. In all experiments, the Krebs solution also contains methiothepin 10'^M and granisetron 10" 6 M to block effects at 5-HTι , 5-HT2 and 5-HT3 receptors. After construction of a simple concentration-response curve with 5-HT, using 30s contact times and a 15min dosing cycle, a concentration of 5-HT is selected so as to obtain a contraction of the muscle approximately 40-70% maximum(10"^M approx). The tissue is then alternately dosed every 15min with this concentration of 5-HT and then with an approximately equi-effective concentration of the nicotine receptor stimulant, dimethylphenylpiperazinium (DMPP). After obtaining consistent responses to both 5-HT and DMPP, increasing concentrations of a putative 5-HT4 receptor antagonist are then added to the bathing solution. The effects of this compound are then determined as a percentage reduction of the contractions evoked by 5-HT or by DMPP. From this data, PIC50 values are determined, being defined as the -log concentration of antagonist which reduces the contraction by 50%. A compound which reduces the response to 5-HT but not to DMPP is believed to act as a 5-HT4 receptor antagonist. The compound of Example 1 had a PIC50 value of 6.78 (± 0.11) (n=4)

Claims: Claims Compounds of formula (I),or a pharmaceutically acceptable salt thereof: (I) wherein in which X]-(CH2) X -X2 and the aromatic carbon atoms to which they are attached form a 5-7 membered ring wherein X ] is O or S; X2 is O, S, NR S or NR s CO wherein R s is hydrogen or C\. alkyl;or one of X\ and X2 is O, S or CH2 and the other is CH2; x is 1, 2 or 3; Rj and R2 together are Q-CH2-CH2, Q-CH=CH, or Q-CH=N where Q is linked either to the Rj or the R2 substutution position and Q is O, S or NR t wherein R t is hydrogen or C- g alkyl; R3 is hydrogen, halo, C\. alkyl, Ci .g alkoxy or amino; R4 1 and R4 2 are independently hydrogen or Cj.g alkyl; Y is O or NH; Z is of sub-formula (a), (b) or (c): (a) (b) (c) wherein n 1 is 1, 2, 3 or 4; n 2 is 0, 1, 2, 3 or 4; n 3 is 2, 3, 4 or 5; q is 0, 1, 2 or 3; p is 0, 1 or 2; m is 0, 1 or 2; R5 is hydrogen, Cj.i2 alkyl, aralkyl or R5 is (CH2) z -Rιo wherein z is 2 or 3 and R 10 is selected from cyano, hydroxyl, C .5 alkoxy, phenoxy, C(O)C \ .5 alkyl, COC6H5, -CONR11R12. NRj ιCOR 1 , SO2NR11R12 or NRj 1SO2R12 wherein R^ and Rj2 are hydrogen or Ci.g alkyl; or R5 is straight or branched chain alkylene of chain length 1-6 carbon atoms terminally substituted by aryl, 3 to 8 membered cycloalkyl, 3 to 8 membered heterocyclyl, 5 or 6 membered monocyclic heteroaryl or 9 or 10 membered fused bicyclic heteroaryl linked through carbon, C2.7 alkoxycarbonyl, or secondary or tertiary hydroxy substituted Ci.g alkyl; ; and Rβ, R7 and Rg are independently hydrogen or Cj_6 alkyl; and R9 is hydrogen or C-μio alkyl; or a compound of formula (I) wherein the CO-Y linkage is replaced by a heterocyclic bioisostere; having 5-HT4 receptor antagonist activity. 2. A compound according to claim 1 wherein Rj and R2 are joined to form -NH-CH=N-. 3. A compound according to claim 1 or 2 wherein the moiety attached to CO-Y-Z is that which is as contained in any of the Examples described herein. 4. A compound according to any one of claims 1 to 3 wherein Z is of sub-formula (a) and (CH2) n l is attached at a carbon atom of the azacycle. 5. A compound according to claim 4 wherein Z is N-substituted 4-piperidinylmethyl. 6. A compound according to claim 5 wherein the N-substituent is C2 or greater alkyl, or optionally substituted benzyl. 7. (l-Butyl-4-piperidinyl)methyl lH-7,8-dihydro-[l,4]- dioxino[2,3-g]benzimidazole-5-carboxylate. 8. A compound according to any one of claims 1 to 7 wherein Y is NH. 9. A process for preparing the ester or amide compounds (where Y is O or NH) according to claim 1, which comprises reacting an appropriate acid derivative with an appropriate alcohol or amine. 10. A pharmaceutical composition comprising a compound according to any one of claims 1 to 8, and a pharmaceutically acceptable carrier. 11. A compound according to claim 1 for use as an active therapeutic substance. 12. The use of a compound according to claim 1 in the manufacture of a medicament for use as a 5-HT4 receptor antagonist. 13. The use according to claim 12 for use as a 5-HT4 receptor antagonist in the treatment or prophylaxis of gastrointestinal disorders, cardiovascular disorders and CNS disorders.

Inventors: GASTER LARAMIE MARY, WYMAN PAUL ADRIAN, GASTER, LARAMIE, MARY, WYMAN, PAUL, ADRIAN
Applicants: GASTER LARAMIE MARY, SMITHKLINE BEECHAM PLC, WYMAN PAUL ADRIAN, GASTER, LARAMIE, MARY, WYMAN, PAUL, ADRIAN
Application year: 1994
Main classification: C07D491
IPC codes: A61K31, A61P1, A61P9, C07D491